Clinical Review

Partnering With Patients to Optimize Diabetes Therapy

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Selecting diabetes medications based on how they can best address the patient’s hyperglycemic pattern is a glucose-centric approach. Perhaps even more important to the overall success of diabetes management, however, is the clinician’s ability to partner with the patient to choose the appropriate agent. Here is a pragmatic framework demonstrating both glucose- and patient-centric approaches you can use when selecting diabetes medications.



 

References

IN THIS ARTICLE
• Fasting versus postprandial glucose contribution to A1C
• General glycemic targets for individuals with T2DM
• Sonja's blood glucose log
• Glycemic impact of noninsulin agents available for T2DM
• Considerations when determining glycemic targets

“… Our ability to help others is a source of pride and satisfaction; however, if we listen, really listen to our patients, we may discover that they are also experts, problem-solvers, and teachers. If we allow our patients to also be our teachers, we may someday realize that although we began with knowledge, we ended up with wisdom.” — 1,000 Years of Diabetes Wisdom
(Marrero DG et al, eds)

The pharmacotherapeutic options available for the treatment of type 2 diabetes mellitus (T2DM) have expanded exponentially in the past 15 years. Although this is great news, having so many therapeutic options has led to confusion for both patients and health care providers (HCPs) as they consider which agent or combination of agents is most appropriate for glucose management, while also considering efficacy, safety, adverse effects, patient preferences, and cost.

Current expert recommendations and guidelines provide algorithms that assist the HCP with selecting medications based on safety (avoiding hypoglycemia), adverse-effect profile (eg, weight gain), and efficacy (predicted A1C reduction). These same guidelines also recommend that the choice of antihyperglycemic agent(s) be individualized according to the patient’s health status and personal preferences.

True success in diabetes management requires not only the knowledge and expertise of the clinician, but also the active involvement of the patient as a partner in health care decision making.

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